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Table Of Contents

Plan Eligibility
Participating Employers
Non-affiliated Employees
Partners and Owners
Employee Shareholders
Permanent Facilities
Contributions
Work Hours
Delinquent Contributions
Delinquent Employee Shareholders
Loan-Out Companies
Improperly Reported Hours
Late Hours Processing
Grievance Settlement
Qualifying Standards
Initial Eligibility
Continuing Eligibility
Eligibility Notification
Eligible Dependent Family Members
Same-Sex Domestic Partner Coverage
Coverage Provided
Divorce Notification Requirements
Establishing Coverage
California Resident Requirements
Relevant Tax Laws and Costs
COBRA Costs
Termination of Same-Sex Domestic Partnership
Surviving Dependent Coverage
Falsification of Status
Your Plan Options
Medical Plan Selection for the Newly Eligible
Dental Plan Selection for the Newly Eligible
Medical and Dental plan selection
Initial Eligibility Packet
Benefit Cards - Alternate Health Plans
Benefit Cards - Dental
Loss of Benefit Cards
ELIGIBILITY INFORMATION PACKETS AND IDENTIFICATION CARDS
Beneficiary/Enrollment Card
your beneficiary/enrollment card
Open Enrollment
HIPAA Special Enrollment
Required Dependent Documentation
Change of Address
Selection Form
Extension Form
When Coverage Ends
Notice of Ineligibility
Certificate of Creditable Coverage
Family and Medical Leave Act (FMLA)
Disability Extensions
Short-Term Disability - 6 Months
CHART OF DISABILITY EXTENSIONS
Long-Term Disability - 18 Months
Combining Extensions
Permanent Disability Extension - Retirement
For Participants
Requirements for COBRA Coverage
Core and Non-core Benefits
Second Qualifying Event
Plan Contact Information
Coverage Conversion Alternatives
Self-Payment Under USERRA
Student Eligibility
Qualified Medical Child Support Orders
Certification of Retirement
Basic Requirements
Effective Date of Benefits
Duration of Eligibility
Benefit Changes Upon Retirement
Work After Retirement
Hospital Services
MPIHP/Blue SHIELD Health Plan Option
MPIHP/Blue Shield Health Plan Option
General Information
Skilled Nursing/Extended Care Facility
Emergency Outpatient Care
Inpatient Care
Hospital Expense benefits
Childbirth
Surgical Centers
Hospital Care/Admissions
Services Not Covered
Information of Note
Covered Services
Second Surgical/Medical Opinion
Experimental and Investigational Exclusion
Preauthorization
Submission and Payment of Claims
Physician Services
Coverage Rates by Provider Categories
Surgical Services
Anesthesiologists
Co-Payment
Maximum Benefits
Billing Errors
Stop Payment or Replacement of a Benefit Check
Order of Benefit Determination
Claims Involving Third Party Liability
Workers’ Compensation
Acupuncture
Alcoholism/Chemical Dependency and Mental Health
Aquatic Therapy
Birth Control Devices
Bone Mineral Density Measurement
Botulism Toxin
Cardiac Rehabilitation
Case Management
Chiropractic Treatment
Colonoscopy
Cosmetic Surgery
Dental Treatment
Dermatology
Diabetes Supplies and Insulin
Diagnostic Imaging and Laboratory Tests
Disease Management Program
Durable Medical Equipment
Emergency Room Treatment
Genetic Testing
Home Hospice Care
Home Intravenous Therapy
Immunizations/Vaccinations
Lens Replacement Following Cataract Surgery
Mammography
Maternity Benefits
Mental Health and Chemical Dependency
Nutrition Counseling
Nutritional Support
Physical Examinations
Physical/Occupational/Aquatic/Osteopathic Manipulative Therapies (Outpatient)
Prostheses and Braces
Reconstructive/Cosmetic Surgery
Speech Therapy
Temporomandibular Joint Dysfunction (TMJ)
Transplants
Weight Control
Wigs/Hair Pieces
Filing An Appeal with MPIHP
Motion Picture & Television fund service Area
Service Area ZIP Codes
Schedule of Benefits
BEhavioral Health
PacifiCare Behavioral Health
Health plan alternatives
Health Net
Continuous Eligibility
Plan Costs
Plan Selection
Primary Differences
Dental Plans Comparison Chart
Delta Dental PPO Dental Plan
DeltaCare USA Dental Health Plan
Life Insurance for Employees
Designating a Beneficiary
Total and Permanent Disability
Accelerated Benefits for Terminal Illness
Costs and Co-Payments
Reimbursement Process
Medco Health Home Delivery
Specialty Medications
Out of the Country
Further Information/Disputes
The Wellness Program
Lifestyle Enhancement Programs
Healthy Family Services
Family Learning Series
Awareness & Learning Resources
Toll-Free Wellness Line
Fully-Insured Benefits
Self-Insured Benefits
American Specialty Health Networks, Inc
EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974
Board of Directors
Change of Address Card
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Published by tvmixer

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Published by: tvmixer on Mar 03, 2011
Copyright:Attribution Non-commercial

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03/03/2011

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